The Pharmaceutical Journal
Vol 279 No 7459 p11
7 July 2007

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Pharmacist prescribing reduces benzodiazepine consumption

Pharmacist supplementary prescribing benzodiazepine reduction clinic

Pharmaceutical Care Awards

The Pharmaceutical Care Awards 2006 were presented at a celebratory dinner on 29 June 2007 at Apothecaries’ Hall, London. The dinner followed a conference at the Royal Pharmaceutical Society’s headquarters, where the finalists presented their projects to an audience of invited guests. The awards, organised by The Pharmaceutical Journal, are sponsored by GlaxoSmithKline and the Company Chemists’ Association

A clinic run by pharmacist supplementary prescriber Heather Climson saw benzodiazepine prescribing reduce from 23,263 doses in December 2005 to 13,828 doses in November 2006. That 41 per cent reduction was considered by this year’s judges to be worthy of a 2006 Pharmaceutical Care Award.

In 2005, a Lanarkshire-wide strategy for the reduction of hypnotics and anxiolytics was published. As part of that strategy, primary care pharmacists were asked to target practices within their localities that had high prescribing rates of these drugs.

So with the support of local GPs, Mrs Climson set up — along with the practice manager — a weekly clinic at a GP practice in Burnbank, a deprived area of Hamilton, where benzodiazepine was recognised to be high. The aim was to reduce benzodiazepine consumption.

Through looking at prescribing records, Mrs Climson identified 321 patients as receiving repeat prescriptions for benzodiazepines. Of these, 252 were identified as being suitable for invitation to the withdrawal clinic. The clinic was set up on a Wednesday afternoon. Twenty-minute consultations were allocated for an initial visit and 10 minutes for a follow up review. During the initial consultation patients were informed about the programme and, if they agreed, a clinical management plan was signed and the reduction programme started.

Presenting her project, Mrs Climson reported that, by March this year, 77 patients had stopped using benzodiazepines and 91 were currently attending the reduction clinic. A further 84 were still on repeat prescriptions but were on a waiting list for the reduction clinic. She added that funding for the clinic has been guaranteed until March 2008, by which time she hoped to see a further substantial drop in doses.

Mrs Climson said that her project dealt with an area of concern that many GP practices were reluctant to address and it was making a real difference to the practice and to patients. Additionally, the project had inadvertently improved the care of patients who were not taking benzodiazepines: referral of benzodiazepine patients to the pharmacist-led reduction clinic had freed GP appointment time for them. All in all, the project had produced significant results.